The effectiveness of specialized legal counsel and case management services for indigent offenders with mental illness.

Bouffard J, Berger E, Armstrong GS - Health Justice (2016)

Bottom Line:
These offenders were compared to 117 similar offenders who did not receive these services, on both their length of stay in the jail, and their likelihood of recidivism after release to the community.Survival analyses revealed that program participants spent about 17 fewer days in jail; however, recidivism rates between groups, measured as return to the same county jail or as statewide re-arrest, did not differ.These results suggest that defendants with mental illness can potentially be managed effectively in the community, with little added risk to public safety and at potential savings in jail bed days/costs.

Background: In recent years, jurisdictions have recognized the strain placed on limited existing resources by criminal offenders with mental illness who frequently cycle through local jail facilities. In response, many locales have developed and implemented specialized programs to more effectively and efficiently manage these offenders, particularly the process of assigning defense attorneys to these often indigent defendants.

Methods: The current study examined the impact of an Indigent Defense Counsel (IDC) program designed to provide specially trained defense attorneys, and enhanced case management services to 257 indigent jail inmates with a qualifying, major mental health diagnosis (e.g., major depression). These offenders were compared to 117 similar offenders who did not receive these services, on both their length of stay in the jail, and their likelihood of recidivism after release to the community.

Results: Survival analyses revealed that program participants spent about 17 fewer days in jail; however, recidivism rates between groups, measured as return to the same county jail or as statewide re-arrest, did not differ.

Conclusions: These results suggest that defendants with mental illness can potentially be managed effectively in the community, with little added risk to public safety and at potential savings in jail bed days/costs. Implications for the processing of indigent criminal defendants with mental illness are presented.

Fig1: Survival Functions for Return to Jail (for any reason) by Groups

Mentions:
Results for the model predicting return to jail for any reason reveal that participation in the IDC program (β = −.116, S.E. = .226, n.s.) did not significantly impact the probability of this outcome (see Table 3). However, males had significantly lower probability of return to jail for any reason than females (β = −.708, S.E. = .223, p < .01), as did non-White relative to White defendants (β = −.726, S.E. = .347, p < .05); while felony level defendants (β = .504, S.E. = .226, p < .05) and those with more prior arrests had a significantly higher likelihood of return to jail (β = .109, S.E. = .020, p < .01). Finally, regardless of whether the individual was in the IDC or comparison sample, those who spent days in jail prior to release had a significantly lower probability of return to the jail for any reason (β = −.013, S.E. = .004, p < .01). Several other variables were marginally related to increased odds of return to jail for any reason, including Hispanic ethnicity and having been charged with a violent crime, while older individuals were marginally less likely to be re-incarcerated. Figure 1 depicts the survival curves for the MAC (dashed line) and comparison samples over time and generally reveal minimal differences in the rate at which each group survived (i.e., was not re-arrested; in consideration of space constraints figures depicting the other two recidivism measures are not presented though the patterns are similar).Fig. 1

Fig1: Survival Functions for Return to Jail (for any reason) by Groups

Mentions:
Results for the model predicting return to jail for any reason reveal that participation in the IDC program (β = −.116, S.E. = .226, n.s.) did not significantly impact the probability of this outcome (see Table 3). However, males had significantly lower probability of return to jail for any reason than females (β = −.708, S.E. = .223, p < .01), as did non-White relative to White defendants (β = −.726, S.E. = .347, p < .05); while felony level defendants (β = .504, S.E. = .226, p < .05) and those with more prior arrests had a significantly higher likelihood of return to jail (β = .109, S.E. = .020, p < .01). Finally, regardless of whether the individual was in the IDC or comparison sample, those who spent days in jail prior to release had a significantly lower probability of return to the jail for any reason (β = −.013, S.E. = .004, p < .01). Several other variables were marginally related to increased odds of return to jail for any reason, including Hispanic ethnicity and having been charged with a violent crime, while older individuals were marginally less likely to be re-incarcerated. Figure 1 depicts the survival curves for the MAC (dashed line) and comparison samples over time and generally reveal minimal differences in the rate at which each group survived (i.e., was not re-arrested; in consideration of space constraints figures depicting the other two recidivism measures are not presented though the patterns are similar).Fig. 1

Bottom Line:
These offenders were compared to 117 similar offenders who did not receive these services, on both their length of stay in the jail, and their likelihood of recidivism after release to the community.Survival analyses revealed that program participants spent about 17 fewer days in jail; however, recidivism rates between groups, measured as return to the same county jail or as statewide re-arrest, did not differ.These results suggest that defendants with mental illness can potentially be managed effectively in the community, with little added risk to public safety and at potential savings in jail bed days/costs.

Background: In recent years, jurisdictions have recognized the strain placed on limited existing resources by criminal offenders with mental illness who frequently cycle through local jail facilities. In response, many locales have developed and implemented specialized programs to more effectively and efficiently manage these offenders, particularly the process of assigning defense attorneys to these often indigent defendants.

Methods: The current study examined the impact of an Indigent Defense Counsel (IDC) program designed to provide specially trained defense attorneys, and enhanced case management services to 257 indigent jail inmates with a qualifying, major mental health diagnosis (e.g., major depression). These offenders were compared to 117 similar offenders who did not receive these services, on both their length of stay in the jail, and their likelihood of recidivism after release to the community.

Results: Survival analyses revealed that program participants spent about 17 fewer days in jail; however, recidivism rates between groups, measured as return to the same county jail or as statewide re-arrest, did not differ.

Conclusions: These results suggest that defendants with mental illness can potentially be managed effectively in the community, with little added risk to public safety and at potential savings in jail bed days/costs. Implications for the processing of indigent criminal defendants with mental illness are presented.